AI That Protects Patients and Strengthens Hospice Integrity

Empowering hospices with intelligent auditing and predictive analytics — ensuring every dollar supports the right patient, at the right time, for the right reasons.

Try the Compassionate Care Advisor

Ask questions about hospice eligibility, fraud detection, compliance, or any aspect of our AI solution

CA
Compassionate Care Advisor
Ask about fraud reduction & eligibility
👋 Hi! I'm the Compassionate Care Advisor. I use AI to help hospice providers identify patient eligibility, forecast future qualification, and ensure the right care at the right time. You can also upload PDFs and images for analysis! How can I help you today?

The Problem

Hospice care was founded on compassion, but across the U.S. it faces a crisis of integrity:

Exponential Growth Issues

Exponential growth in hospice providers with flat patient numbers

Rising Medicare Spending

Medicare spending rose from $20.5B in 2019 to $25B in 2023

Inappropriate Admissions

Live discharge rates increased to 18.2% in 2023, signaling inappropriate admissions

Fraud & Billing Abuse

Over $1.2B in non-hospice spending among hospice-enrolled patients, rising rates of fraud

Traditional auditing methods cannot keep pace with these issues — the system demands continuous, intelligent oversight.

The Solution: AI-Driven Oversight

The Hospice AI Advisor leverages machine learning to detect fraud, improve compliance, and ensure ethical hospice admissions.

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Continuous Monitoring

Tracks claims in real-time to identify anomalies

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Automated Compliance

Cross-checks hospice claims with CMS criteria instantly

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Predictive Eligibility

Uses patient data to forecast when hospice care will be appropriate

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Fraud Detection

Flags unusual billing or discharge patterns

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Insightful Reporting

Generates reports that improve CMS oversight and provider trust

How It Works

Four seamless steps to transform hospice oversight

1

Integrate

Connect seamlessly with hospice EHR and billing systems

2

Analyze

AI reviews documentation, diagnoses, and utilization trends

3

Alert

Identifies fraud signals or early eligibility indicators

4

Report

Produces actionable data dashboards for decision-makers

Measurable Benefits

Proven improvements for hospices, CMS, and patients

85%

Reduction in Inappropriate Admissions

AI-powered eligibility screening ensures only appropriate patients are admitted to hospice care

$2.3M

Average Annual Savings

Per healthcare system through improved compliance and reduced audit penalties

92%

Fraud Detection Accuracy

Industry-leading precision in identifying billing irregularities and documentation fraud

AI in Action

Real examples of fraud detection and compliance prediction

🚨 Fraud Detection Alert

Pattern Detected: Unusual Discharge Timing

Provider XYZ shows 47% live discharge rate vs. industry average of 18.2%. AI flagged 23 cases with similar patterns suggesting potential inappropriate admissions.

Recommended Action: Immediate review of admission criteria and clinical documentation for flagged cases.

✅ Compliance Prediction

Early Eligibility Indicator

Patient Jane D. (DOB: XX/XX/XXXX) shows prognostic indicators suggesting 6-month life expectancy. Current treatment trajectory aligns with hospice appropriateness criteria.

Recommended Action: Clinical team consultation for potential hospice referral discussion.

📊 Documentation Analysis

Missing Documentation Alert

Claims submitted for Patient ID #12345 missing required physician certification. CMS audit risk increased by 34% without proper documentation.

Recommended Action: Obtain missing physician signatures before next billing cycle.

About Compassionate Solutions

Founded on the principle that technology should enhance, not replace, the human element in healthcare. Our mission is to use AI to create ethical and efficient hospice care — reducing fraud while ensuring patients who need hospice get the right support at the right time.

Ethical AI

Built with fairness, transparency, and clinical oversight as core principles

Patient-Centered

Every feature designed to improve patient care and family support

Compliance First

Helping providers meet CMS requirements while reducing administrative burden

Partners & Compliance

Aligned with industry standards and regulatory requirements

CMS Alignment

Medicare Guidelines Compliance

Built on current CMS hospice eligibility criteria and billing requirements

Quality Reporting Integration

Supports CAHPS and HIS quality measure reporting

Audit Preparation Support

Automated documentation review for CMS compliance audits

Security & Privacy

HIPAA Compliant

End-to-end encryption and secure data handling protocols

SOC 2 Type II Certified

Rigorous security controls and annual compliance audits

Zero Data Retention

Patient data processed and purged according to retention policies

Comprehensive Hospice Eligibility Criteria

CMS-compliant assessment guidelines built into our AI system

Core Eligibility Requirements

6-Month Prognosis

Terminal illness with 6-month life expectancy if disease runs normal course

Physician Certification

Attending physician + hospice medical director certification required

Patient Election

Informed consent and election of hospice care by patient/family

Comfort Care Focus

Emphasis on comfort care versus curative treatment approaches

Functional Decline Indicators

Performance Scales

  • • Karnofsky ≤50%
  • • ECOG ≥3
  • • Dependence in 3+ ADLs

Physical Decline

  • • Recurrent falls
  • • Decreased ambulation
  • • Progressive weakness

Nutritional Status

  • • Weight loss >10% in 6 months
  • • Albumin <2.5 g/dL
  • • Declining oral intake

Disease-Specific Eligibility Criteria

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Cancer

  • • Metastatic or locally advanced disease
  • • Karnofsky ≤50% or ECOG ≥3
  • • Treatment failure or refusal
  • • Declining performance status
❤️

Cardiac

  • • NYHA Class IV heart failure
  • • Ejection fraction ≤20%
  • • 3+ hospitalizations in 12 months
  • • Optimal therapy maximized
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Pulmonary

  • • FEV1 <30% predicted
  • • O2 saturation ≤88% on O2
  • • Cor pulmonale
  • • Recurrent pneumonia
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Neurological

  • • Advanced dementia (FAST 7C)
  • • Unable to ambulate/dress/bathe
  • • Minimal verbal communication
  • • Recurrent infections
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Renal

  • • CrCl <10 mL/min
  • • Serum creatinine >8.0 mg/dL
  • • Dialysis refusal/discontinuation
  • • Uremia, hyperkalemia
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Liver

  • • Cirrhosis with complications
  • • Refractory ascites
  • • Spontaneous bacterial peritonitis
  • • Hepatorenal syndrome

Documentation Requirements

Required Documentation

  • Initial physician certification within 15 days
  • Face-to-face encounter within 30 days (recertification)
  • Clinical notes supporting terminal prognosis
  • Care plan focusing on comfort measures
  • Patient election statement with informed consent

Red Flags (Inappropriate Admissions)

  • Stable chronic conditions without decline
  • Active curative treatment ongoing
  • Functional status too high (Karnofsky >50%)
  • Admission for social/convenience reasons
  • Lack of terminal diagnosis documentation

AI Assessment Response Format

Our AI provides structured, clinical assessments using this format:

1. Eligibility Determination

ELIGIBLE / NOT ELIGIBLE / NEEDS DOCUMENTATION

2. Supporting Criteria

Specific indicators met or missing

3. Missing Elements

Required documentation gaps

4. Regulatory Compliance

CMS requirement status

Advanced Clinical Assessment Tools

Specialized scoring systems and frameworks integrated into our AI analysis

Performance & Functional Assessment

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Karnofsky Performance Scale

  • 100-80: Normal activity, minor symptoms
  • 70-50: Cannot work, considerable assistance
  • 40-20: Disabled, requires special care
  • ≤50%: Hospice Eligible
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ECOG Performance Status

  • 0: Fully active, no restrictions
  • 1: Restricted in strenuous activity
  • 2: Ambulatory, up >50% of time
  • ≥3: Hospice Eligible
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FAST Scale (Dementia)

  • Stage 6: Basic ADL assistance needed
  • Stage 7A: Limited vocabulary (<6 words)
  • Stage 7C: Hospice Eligible
  • Cannot walk, sit up, smile, or hold head up

Disease-Specific Assessment Frameworks

Cardiac Assessment (NYHA Classification)

Class I-II

Minimal limitations, comfortable at rest

Class III

Marked limitation, less than ordinary activity

Class IV

Hospice Eligible: Symptoms at rest

Pulmonary Assessment (GOLD Staging)

GOLD 1-2

FEV1 >50%, mild-moderate limitation

GOLD 3

FEV1 30-50%, severe limitation

GOLD 4

Hospice Eligible: FEV1 <30%

Laboratory & Biomarker Indicators

Nutritional Markers

  • Albumin:<2.5 g/dL
  • Prealbumin:<10 mg/dL
  • Weight Loss:>10% in 6 months
  • BMI:<18.5

Renal Function

  • Creatinine:>8.0 mg/dL
  • CrCl:<10 mL/min
  • BUN:>80 mg/dL
  • Urine Output:<400 mL/day

Cardiac Markers

  • Ejection Fraction:≤20%
  • BNP:>400 pg/mL
  • Troponin:Persistently elevated
  • Sodium:<130 mEq/L

Advanced Prognostic Indicators

Surprise Question

"Would I be surprised if this patient died within 6-12 months?"

Answer "No" = Consider hospice

Decline Trajectory

Progressive functional decline over 3-6 months

Multiple hospitalizations

Treatment Response

Diminishing response to optimal therapy

Side effects outweigh benefits

Quality of Life

Significant symptom burden impacting daily life

Family/patient goals shift to comfort

Regulatory Compliance Framework

CMS guidelines and Medicare requirements integrated into our AI system

Medicare Coverage Criteria (42 CFR 418)

Certification Requirements

1

Initial Certification

Attending physician + hospice medical director within 15 days

2

Recertification

Face-to-face encounter within 30 days prior to 3rd benefit period

3

Narrative Statement

Clinical findings supporting 6-month prognosis

Benefit Periods

Initial Period

90 days - Physician certification required

Subsequent Period

90 days - Physician certification required

Extended Periods

60 days each - Face-to-face + certification required

Quality Reporting & Audit Compliance

CAHPS Hospice Survey

  • • Communication with family
  • • Emotional support provided
  • • Help with pain and symptoms
  • • Training family to care for patient
  • • Rating of hospice care

HIS Quality Measures

  • • Patients treated with opioids who are given bowel regimen
  • • Patients who believe they got right amount of medicine for pain
  • • Patients whose shortness of breath was addressed
  • • Patients treated with appropriate level of care

Documentation Standards

  • • Plan of care updates every 15 days
  • • Interdisciplinary team meetings
  • • Medication management records
  • • Family conference documentation
  • • Volunteer contact logs

AI-Powered Fraud Prevention Indicators

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Length of Stay Anomalies

Unusually long stays without clinical justification

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Live Discharge Patterns

High rates of patients discharged alive after short stays

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Diagnosis Clustering

Overconcentration in specific, profitable diagnoses

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Documentation Gaps

Missing face-to-face encounters or certifications

Resources & Insights

Latest research and data supporting AI in hospice care

📊 Featured Report: Hospice Monitoring Report 2024

Comprehensive analysis of hospice care trends, compliance challenges, and opportunities for AI-driven improvements in the healthcare system.

Download Full Report (PDF)

CMS Data Analysis

Our analysis of 2019-2023 Medicare hospice spending data reveals critical trends in inappropriate utilization and billing patterns.

Read Full Report

AI in Healthcare White Paper

Comprehensive guide to implementing machine learning for healthcare fraud detection and compliance monitoring.

Download PDF

Industry Best Practices

Evidence-based recommendations for hospice providers to improve compliance and patient outcomes through technology.

View Guidelines

Additional Resources

📈 Market Research

Quarterly reports on hospice industry trends and regulatory changes

🔬 Technical Documentation

API documentation and integration guides for healthcare systems